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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />CITY PERMIT NO. 7921 <br />Date <br />Owner f--V/-5&7A Address S- 4+wde7i�621- <br />Contractor Address 6 <br />, WiPu <br />City License No.State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION <br />Inside Plumbing Ofixt}�res_) Fee S q <br />Water Meter, Size•Jfq—G�} Fee S <br />Meter# <br />Remote $ // 9- TV 77[0 <br />Municipal Water Connection Fee S <br />[Copper ❑ <br />Municipal Sewer Connection <br />❑ PVC ❑ Cat <br />MWCC SAC- Charge <br />On Site Septic SYF"-Til <br />ACKNOWLEDGEMENT <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />!Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fac S _- ---- <br />Fire Fee S <br />n <br />Fee S _ <br />nkler System (Fire) <br />her: <br />Fee S After -the -fart Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special Information, <br />terms, conditions or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified: that Uds permit does <br />not pant any authority to do work or activities requiring <br />separate permit approvals: and that this permit does not <br />pant authority to violate any provision of soy City <br />ordinance or State law, rule or regulation. Ali work shall be <br />done in suiet compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subject to inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be In violation of the conditions of <br />this permit. <br />Signa(ure PLApplicant <br />TOTAL <br />Fee S <br />Fee e <br />Fee S <br />State Surcharge: Fee S _, <br />Total Amount Paid to City Fee S-915-, (IT-) <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City <br />Code: White - - File Copy Canary Inspector's Copy Pink -Finance Copy <br />L-0 CrN <br />Gold --Applicant's Receipt <br />